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Estrogen patches: Anyone used an estrogen patch post-ADT? Helpful?
I just had my second post-ADT PSA test and it dropped from .08 to .04 so I am very happy about that as my primary treatment was SBRT not RP.
My testosterone level, though, has actually declined since the first post-ADT test. It went from unmeasurable to 380, but is now 320, which I'm told is still low normal.
However, my estradiol levels are VERY low--at 4 where the minimum is 10.
Both my radiation oncologist and medical oncologist feel I should wait for at least a year after treatment before trying to raise my testosterone levels.
They are split, however, on whether I should temporarily wear an estrogen patch.
I feel considerably better than I did while on ADT, but still not great. I'm moody, my hips and back hurt, and my energy level is low. The medical oncologist feels a patch may eliminate a lot of these problems while the radiation oncologist feels the effect, if any, would be minimal and that the main side effect (possible breast growth) makes waiting a more preferable option. I had a DEXA scan but the results won't be available for a week.
Has anyone here used an estrogen patch post-ADT? Was it helpful?
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The estrogen patch is a replacement for ADT. The patch trial just completed and discusses how the estrogen patch is just as successful as ADT at suppressing testosterone. Lots of benefits to having the estrogen, but it also lowers your testosterone, Not sure how much you would be taking, maybe not enough to reduce testosterone much, but if it did, it could put you back where you were with low testosterone.
Wow, thank you! I'm really surprised neither doctor mentioned this. Maybe they're thinking a really low dose to ease the symptoms? Maybe I should just tolerate it until the year is up and I can do low-dose T replacement therapy. Just a bit bummed because I thought all the ADT side effects would be gone by now and they're still hanging on. Thanks again.
Don’t understand how the patch would increase your T…it’s estrogen! If anything it will reduce T.
The PATCH trial found estradiol patch very successful as a different delivery system - via the skin instead of the blood, less effects on the liver.
But it was basically an ADT delivery system so I’m not sure what they’re thinking…
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1 ReactionMy T is low normal but my Estradiol is very low which could be causing some of the symptoms I'm having. Apparently, both are necessary. My medical oncologist does a FULL testosterone workup that includes Sex Hormone Binding Globulin, Estradiol, Luteinizing Hormone, Prolactin, Testosterone Total and Testosterone Free.
Testosterone was decent last time but has dropped instead of going up. It's still in the low normal range (barely). Estradiol is abnormal at 4. Luteinizing Hormone is off the charts high at 18 (9 should be the max) which mean my pituitary gland is telling my body to make more testosterone and estrogen but my body isn't listening so it's cranking up the volume. I think the doctor talking about a patch means a very low dose, not a testosterone-depleting dose but need to clarify that with him since it does sound unconventional (which is probably why the radonc is not recommending it).
I was feeling OK but have started feeling crappy again with a lot of the side effects I had on ADT (insomnia, moodiness, hip and back pain, depression, tiredness, etc.) even though I've been off it almost six months and all the Orgovyx should be long gone. Dr. Google says all this could be a sign of testicular failure but my doctor says not to jump to that conclusion just yet.
The only good thing is my PSA dropped again to .04 but I just want to feel like myself again.
I am surprised they gave you a year. My oncologist insisted that he would never start me on T-replacement. I caught my cancer very early and had it removed. My family PA that treats all sorts of hormone issues told me she would allow me T-replacement if I had PSA of < .01 every 3 months for 3 years and had a PMSA scan that was clean. I did that and started T 2 years ago. Mine was 320 when I started and I keep it at about 650 to 700. My estradiol runs about 25-30. I use a cream. I feel much better but no help with erections.
@heavyphil Misread your comment about Wearing an estradiol patch which reduces testosterone just as well as ADT. Sorry
One of the groups I Attend has a GU oncologist come to the second meeting every month. He publishes a newsletter and covered the patch study, which is done in Europe, so there hasn’t been as much information here in the USA.
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1 ReactionJeff, I think we are in agreement in this. Estradiol IS ADT and will lower Scott’s T. Please reread my comment - thanks!
Phil
Scott, perhaps you should show your results to an endocrinologist? Your MO, however, seems to be all over it so not sure what another set of eyeballs would do…
It really looks like your pituitary is working overtime but those two little guys aren’t getting the message. You absolutely do need estradiol, but I think the patch will still lower your T further so the outcome might be a wash.
I do not know enough about the actual patch to know if it comes in dosages or strengths.
You did react rather strongly to your initial dose of ADT so maybe it’s going to take longer to jump start the biological clock?